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01.11.2010 | Breast Oncology | Ausgabe 11/2010

Annals of Surgical Oncology 11/2010

Present-Day Locoregional Control in Patients with T1 or T2 Breast Cancer with 0 and 1 to 3 Positive Lymph Nodes After Mastectomy Without Radiotherapy

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 11/2010
Autoren:
MD Ranjna Sharma, MD Isabelle Bedrosian, MD Anthony Lucci, MD Rosa F. Hwang, MD Loren L. Rourke, MS Wei Qiao, MD Thomas A. Buchholz, MD Steven J. Kronowitz, MD Savitri Krishnamurthy, MD Gildy V. Babiera, MD Ana M. Gonzalez-Angulo, MD Funda Meric-Bernstam, MD Elizabeth A. Mittendorf, MD Kelly K. Hunt, MD, PhD, FACS Henry M. Kuerer
Wichtige Hinweise
Presented in part at the Society of Surgical Oncology 63rd Annual Cancer Symposium Plenary Session, St. Louis, MO, March 6, 2010.

Abstract

Background

We sought to determine present-day locoregional recurrence (LRR) rates to better understand the role of postmastectomy radiotherapy (PMRT) in women with 0 to 3 positive lymph nodes.

Methods

Clinical and pathologic factors were identified for 1019 patients with pT1 or pT2 tumors and 0 (n = 753), 1 (n = 176), 2 (n = 69), or 3 (n = 21) positive lymph nodes treated with mastectomy without PMRT during 1997 to 2002. Total LRR rates were calculated by Kaplan-Meier analysis and compared between subgroups by the log rank test.

Results

After a median follow-up of 7.47 years, the overall 10-year LRR rate was 2.7%. The only independent predictor of LRR was younger age (P = 0.004). Patients ≤40 years old had a 10-year LRR rate of 11.3 vs. 1.5% for older patients (P < 0.0001). The 10-year rate of LRR in patients with 1 to 3 positive nodes was 4.3% (94.4% had systemic therapy), which was not significantly different from the 10-year risk of contralateral breast cancer development (6.5%; P > 0.5). Compared with the 10-year LRR rate among patients with node-negative disease (2.1%), patients with 1 positive node had a similar 10-year LRR risk (3.3%; P > 0.5), and patients with 2 positive nodes had a 10-year LRR risk of 7.9% (P = 0.0003). Patients with T2 tumors with 1 to 3 positive nodes had a 10-year LRR rate of 9.7%.

Conclusions

In patients with T1 and T2 breast cancer with 0 to 3 positive nodes, LRR rates after mastectomy are low, with the exception of patients ≤40 years old. The indications for PMRT in patients treated in the current era should be reexamined.

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